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Background: Estimating the age of majority is a challenging task in forensic odontology, especially because the third molars are usually the only developing teeth between the ages of 16 and 21 years. The London Atlas emerged as an alternative to estimate age using dental development, eruption and deciduous root resorption as parameters. The method has performed well in young age categories, while its performance for age estimation via third molars has been disputed. The present study tested the performance of the London Atlas to estimate the age of legal majority in a sample of individuals from the Amazon Region. Material and Methods: The sample consisted of 1.256 panoramic radiographs of women (n = 694) and men (n = 562) between 16 and 22.9 years. The method was applied to the maxillary (#28) and mandibular (#38) left third molars. For comparative purposes, the sample was divided into seven age groups: 16â 16.99; 17â 17.99; 18â 18.99; 19â 19.99; 20â 20.99; 21â 21.99; and 22â 22.99 years. Chronological and estimated ages were compared descriptively by means of mean absolute errors (MAE) and root mean squared errors (RMSE), as well as through Receiver Operating Characteristic (ROC) curves and their area under the curve (AUC). Results: The MAE of the age estimates using tooth #28 was 1.76 years for females and 1.52 years for males. When the tooth #38 was used, the MAE for the females and males were 1.68 and 1.51 years, respectively. The MAE and RMSE increased in ascending order between age categories. Tooth #28 led to 74% of correct classifications around the age of legal majority, while tooth #38 reached 77%. The area under the curve was 0.75 for tooth #28 and 0.73 for tooth #38. Conclusions: The London Atlas should be used carefully to estimate the age of legal majority and not as a single method when the age threshold is 18 years. Key words:Age determination by teeth, forensic dentistry, forensic science, third molar.
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Dental measurements have been proposed as parameters for stature estimation for at least 85 years. The scientific literature on the topic, however, is controversial regarding the performance of the method. This systematic literature review of observational cross-sectional studies aimed to compile evidence to support decisions in the forensic practice regarding the use of dental measurements for stature estimation. Embase, LILACS, MedLine (via PubMed), SciELO, Scopus, Web of Science, DansEasy and Open Access Thesis and Dissertations (OATD) were searched. Data regarding the rate of correct stature classifications were extracted. A meta-analysis with a Random Intercept Logistic Regression model and a Logit Transformation was conducted. The search led to 10.803 entries, out of which 15 were considered eligible (n = 1486 individuals). The studies were published between 1990 and 2020 and were authored by South American (n = 7) and Asian (n = 8) research teams. Dental measurements were predominantly (93.34â¯%) performed on dental casts or via intraoral inspection. The overall rate of correct classifications based on stature was 68â¯%. Excluding outliers, the overall accuracy of the method decreased to 64â¯% (95â¯%CI: 54-73â¯%). Significant heterogeneity was detected (I² = 72.4â¯%, τ2 = 0.24, H = 1.91, p < 0.001). Egger's test (p = 0.94) and the funnel plot did not reveal publication bias. Dental measurements are not reliable for stature estimation in the forensic field.
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Estatura , Odontología Forense , Humanos , Odontología Forense/métodos , Antropología Forense/métodosRESUMEN
Third molar development is used for dental age estimation when all the other teeth are fully mature. In most medicolegal facilities, dental age estimation is an operator-dependent procedure. During the examination of unaccompanied and undocumented minors, this procedure may lead to binary decisions around age thresholds of legal interest, namely the ages of 14, 16 and 18 years. This study aimed to test the performance of artificial intelligence to classify individuals below and above the legal age thresholds of 14, 16 and 18 years using third molar development. The sample consisted of 11,640 panoramic radiographs (9680 used for training and 1960 used for validation) of males (n = 5400) and females (n = 6240) between 6 and 22.9 years. Computer-based image annotation was performed with V7 software (V7labs, London, UK). The region of interest was the mandibular left third molar (T38) outlined with a semi-automated contour. DenseNet121 was the Convolutional Neural Network (CNN) of choice and was used with Transfer Learning. After Receiver-operating characteristic curves, the area under the curve (AUC) was 0.87 and 0.86 to classify males and females below and above the age of 14, respectively. For the age threshold of 16, the AUC values were 0.88 (males) and 0.83 (females), while for the age of 18, AUC were 0.94 (males) and 0.83 (females). Specificity rates were always between 0.80 and 0.92. Artificial intelligence was able to classify male and females below and above the legal age thresholds of 14, 16 and 18 years with high accuracy.
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Determinación de la Edad por los Dientes , Tercer Molar , Femenino , Humanos , Masculino , Tercer Molar/diagnóstico por imagen , Inteligencia Artificial , Determinación de la Edad por los Dientes/métodos , Diente Molar , Redes Neurales de la ComputaciónRESUMEN
Junto às tecnologias que surgem para aprimorar a Odontologia mundial, emergem temáticas que progressivamente prosperam no obscuro e na incerteza. Tais "áreas odontológicas" se caracterizam por uma roupagem prolixa e de alto apelo público (como por meio de inferências sobre o emocional e os mistérios do corpo humano). Em tempos de disseminação da psiconeurodontologia e (bio)decodificação dental, assim como da incerteza acerca de sua confiabilidade, faz-se imperativa a busca pela fundamentação científica que sustenta esta temática. Para isto, foi realizada uma revisão de escopo seguindo as recomendações do PRISMA-ScR e JBI. Uma ampla busca foi realizada em cinco bases de dados e em parte da literatura cinza. Não houve restrição quanto ao ano de publicação e nem quanto ao idioma. Os dados foram coletados e expostos na forma narrativa/descritiva. De maneira complementar, utilizou-se a ferramenta JBI para avaliação da qualidade metodológica. A busca resultou em 4.785 registros iniciais, dos quais somente dois foram classificados como elegíveis. Ambos os estudos foram detectados a partir da literatura cinzenta e consistiam em trabalhos peruanos de conclusão de curso em nível de graduação (Bacharelado) em Odontologia. Os trabalhos aferiam a ocorrência de lesão de cárie em quadrantes de dentes permanentes e decíduos e correlacionavam com um questionário psicoemocional. Os dois trabalhos concluíram em prol da aplicação da psiconeurodontologia e da (bio)decodificação dental como ferramentas adicionais ao armamentário diagnóstico do Cirurgião-dentista. Detectou-se alto risco de viés, em especial acerca das limitações metodológicas dos estudos elegíveis. Tendo em vista os métodos e resultados observados nos estudos elegíveis, pode-se concluir que não há fundamentação científica na psiconeurodontologia ou na (bio)decodificação dental, muito menos validade e confiabilidade para a sua aplicação na prática clínica odontológica atual
Along with the technologies that emerged to improve Dentistry worldwide, there are themes that progressively dive into darkness and uncertainty. Such "dental areas" are characterized by a verbose approach and strong public appeal (such as through inferences about the emotions and mysteries of the human body). In times of dissemination of psychoneurodontology and dental (bio)decoding, as well as uncertainty about their reliability, the search for alleged scientific foundations that support this theme is imperative. To this end, a scoping review was carried out following the recommendations of PRISMA-ScR and JBI. A broad search was carried out in five databases and part of the gray literature. There was no restriction on the year of publication or language. Data were collected and presented in narrative/descriptive form. Complementarily, the JBI tool was used to assess methodological quality. The search resulted in 4.785 initial records, of which only two were classified as eligible. Both studies were detected from the gray literature and consisted of Peruvian studies at Bachelor's degree in Dentistry. The studies measured the occurrence of caries lesions in quadrants of permanent and deciduous teeth and correlated them with a psychoemotional questionnaire. The two studies concluded in favor of the application of psychoneurodontology and dental (bio)decoding as additional tools to the dental surgeon's diagnostic armamentarium. A high risk of bias was detected, especially regarding the methodological limitations of the eligible studies. Considering the methods and results observed in the eligible studies, it can be concluded that there is no scientific basis in psychoneurodontology or dental (bio)decoding, as well as lack of validity and reliability for its application in current clinical dental practice
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Os dentes supranumerários são uma anomalia e podem ser vistos em todos os quadrantes dos maxilares, com maior incidência na maxila. Quando os dentes supranumerários ocorrem distalmente ao terceiro molar, eles são denominados de dentes distomolares. Os distomolares ocorrem mais comumente unilateralmente na maxila de pessoas negras e afetam 2.2% da população. Por outro lado, a fusão ocorre pela união de dois germes dentários separados, desenvolvendo um único dente unido pela dentina e/ou pelo esmalte. A frequência de fusão de dentes permanentes e supranumerários é menor do que 0.1%, e normalmente envolve dentes anteriores da maxila. Radiografias periapicais são rotineiramente utilizadas em endodontia para o diagnóstico e planejamento pré-operatório, bem como durante o trans e pós-operatório. Entretanto, limitações relacionadas à bidimensionalidade dessa modalidade de imagens podem impedir a visualização adequada da anatomia dos canais radiculares dos dentes com variações anatômicas. O objetivo do presente relato foi descrever um caso raro de fusão por meio da tomografia computadorizada de feixe cônico...
Supernumerary teeth are teeth that occur in addition to the normal series. They can be observed in all quadrants of the jaw, with highest incidence in the maxilla. When a supernumerary tooth is distal to the most posterior molar, it is called a distomolar. Distomolars are more common unilaterally, in the maxilla and in black people and affect 2.2% of the population. In contrast, fusion is the result of the union of two separate tooth germs, forming a single tooth joined by dentin and/ or enamel, and fusion of a permanent tooth with a supernumerary accounts for fewer than 0.1% of cases, usually involving anterior maxillary teeth. Periapical radiographs are routinely used for endodontic diagnosis and preoperative planning, for transoperative guidance and for postoperative follow-up. However, the two-dimensional nature of this imaging technique can impose limitations on the ability to determine the anatomy of root canals in teeth with anatomical variations. The objective of this case report is to describe a rare case of fusion of a distomolar with a third molar, assessed using cone-beam computed tomography (CBCT)...
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Humanos , Femenino , Persona de Mediana Edad , Tercer Molar , Diente Supernumerario , Tomografía Computarizada de Haz CónicoRESUMEN
Aim: To evaluate the reliability of linear measurements in virtual models by comparing measurements performed on virtual models obtained from alginate impression scans, plaster model and measurements performed on conventional plaster model. Methods: The sample comprised 26 randomly selected patients to have impressions of their upper and lower jaws taken using alginate and their bite registration using a wax bite. The virtual models were obtained by scanning the alginate impression and the plaster model in a laser surface scanner (R700; 3Shape, Copenhagen, Denmark), and the measurements were performed using the Ortho Analyser (3Shape) proprietary software. The linear measurements of the size of the teeth mesial to distal, arch perimeter, intercanine distance and intermolar distance in the upper and lower arches were performed on plaster models, digital impressions and digital models, by three observers and repeated after 15 days on 8 models for intra-observer evaluations. Data were tabulated and analyzed statistically. Intra-class correlation to check the agreement of intra and inter-observers and ANOVA test were used to analyze the differences between measurements of digital models from impression and digital models from plaster. Results: The results showed a statistically significant difference (pd"0.05) for the posterior teeth, anterior teeth, upper arch perimeter and lower inter-canine distance, comparing the digital models with plaster models, but these differences are considered clinically non-significant. Conclusions: Digital models were proven be reliable and clinically acceptable for measuring tooth width, perimeter arches, intercanine and intermolar distances.
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Ortodoncia , Modelos Dentales , Diagnóstico , DigitalisRESUMEN
Os aumentos gengivais inflamatórios são áreas que dificultam o controle de placa bacteriana, comprometem a estética e devem ser eliminados cirurgicamente quando associados a um conteúdo fibroso. Dentre as técnicas cirúrgicas empregadas, a gengivectomia é a mais utilizada, porém traz algumas desvantagens nos períodos pós-operatórios iniciais que poderiam ser contornadas com o retalho a bisel interno. Neste trabalho, apresentamos um relato de caso clínico de aumento gengival inflamatório associado a aparelho ortodôntico fixo, através do qual comparamos o comportamento clínico das duas técnicas cirúrgicas a longo prazo. Os resultados demonstraram que, apesar de algumas desvantagens para cada técnica, os dois procedimentos cirúrgicos são eficazes para a eliminação dos aumentos gengivais inflamatórios e previsíveis na manutenção dos resultados ao final de três anos de proservação